Aquatic Animal Foods for Nutrition Security and Child Health

Background: Aquatic animal source foods (AASF) can provide vital nutrients and bioactive factors essential for human health, yet disparities in consumption patterns prevail globally. Limited evidence exists for the implications of AASF access on child health outcomes. Objective: This study aimed to examine global AASF intakes longitudinally in association with critical nutrient intakes and childhood stunting and anemia. Methods: The analysis draws from compiled longitudinal country data (1993-2013) based on a constructed conceptual framework encompassing social and ecological factors that influence fish consumption and human health. Longitudinal generalized linear models were used to estimate the association of apparent AASF intake on country-level nutrient availability (docosahexaenoic acid [DHA], choline, vitamin B12, iron, and zinc) and prevalence of undernourishment, child stunting, and child anemia. Results: Across 175 countries, the median per capita daily apparent intake of all AASF was 37.87 g, with marginally significant differences observed between countries with low (46.65 g) versus high child mortality (23.50 g). The combined category of all AASF was significantly associated with increased total apparent intakes of DHA, choline, and vitamin B12 and reduced child stunting. Finfish (pelagic and demersal) and crustaceans inversely correlated with child stunting, while apparent intakes of mollusks and crustaceans were associated with reduced child anemia. Conclusions: This study uniquely showed that AASF were associated with improved child health outcomes and the critical nutrients necessary for growth, development, and maintaining health throughout the life course. Policies should ensure increased access to AASF across food systems and within sustainable healthy diets globally.

Hubungan Tekanan Darah Tinggi Dengan Kejadian Stunting Pada Anak

ABSTRACT: THE RELATIONSHIP OF HIGH BLOOD PRESSURE WITH STUNTING IN CHILDREN Introduction: Reducing stunting in children is the most important goal of the six goals of the Global Nutrition Targets 2025 and a key indicator in the second Sustainable Development Goal of No Hunger. The prevalence of child stunting in Indonesia has remained high over the last decade, and at the national level it is around 37%. It is unclear whether the current approach to reducing child stunting is in line with the World Health Organization's conceptual framework on child stunting to review the available literature and identify what has been learned and can be concluded about the determinants of child stunting in Indonesia and where data gaps still exist. Community and community factors—in particular, poor access to health care and living in rural areas—have been repeatedly linked to stunted children. Published studies are lacking on how education is; society and culture; agriculture and food systems; and water, sanitation and the environment contribute to child stunting. Purpose: the purpose of the study is to analyze the relationship of high blood pressure with stunting in children.Method: This study uses an observational research with a case control study design and uses a retrospective approach conducted on children with an age range of 5-14 years. The population of this study was 210 children aged 5-14 years, the number of samples in this study was 192 consisting of 64 case samples and 128 control samples. Result: The results showed 64 respondents who were stunted and 128 who did not experience stunting. And the results showed that most infants and toddlers who were stunted had no hypertension status in their mothers during pregnancy as much as 43,51% and 56,49% in infants and toddlers who were not stunted with their mothers during pregnancy. Conclusion: There is a relationship between high blood pressure and the incidence of stunting in children. Keywords: stunting; hypertension;kid’s healty. ABSTRAK: HUBUNGAN TEKANAN DARAH TINGGI DENGAN KEJADIAN STUNTING PADA ANAK Pendahuluan: Pengurangan stunting pada anak merupakan tujuan terpenting dari enam tujuan Global Nutrition Targets 2025 dan indikator kunci dalam Sustainable Development Goal of No Hunger kedua. Prevalensi stunting anak di Indonesia tetap tinggi selama dekade terakhir, dan di tingkat nasional sekitar 37%. Tidak jelas apakah pendekatan saat ini untuk mengurangi pengerdilan anak sejalan dengan kerangka konseptual Organisasi Kesehatan Dunia tentang pengerdilan anak untuk meninjau literatur yang tersedia dan mengidentifikasi apa yang telah dipelajari dan dapat disimpulkan tentang determinan pengerdilan anak di Indonesia dan di mana kesenjangan data masih ada. Faktor masyarakat dan masyarakat—khususnya, akses yang buruk ke perawatan kesehatan dan tinggal di daerah pedesaan—telah berulang kali dikaitkan dengan anak-anak yang terhambat. Studi yang diterbitkan kurang tentang bagaimana pendidikan itu; masyarakat dan budaya; sistem pertanian dan pangan; dan air, sanitasi, dan lingkungan berkontribusi terhadap pengerdilan anak. Tujuan penelitian: penelitian ini bertujuan untuk menganalisa hubungan antara tekanan darah tinggi dan stunting pada anak. Metode Penelitian: penelitian ini menggunakan jenis penelitian observasional dengan rancangan studi case control dan menggunakan pendekatan retrospektif yang dilakukan pada anak dengan rentang umur 5-14 tahun. Populasi dari penelitian ini adalah 210 anak usia rentang 5-14 tahun jumlah sampel dalam penelitian ini adalah 192 yang terdiri dari jumlah sampel kasus 64 dan jumlah sampel kontrol 128. Hasil: Hasilnya menunjukkan 64 responden yang mengalami stunting dan 128 yang tidak mengalami stunting. Dan didapatkan hasil sebagian besar bayi dan balita yang stunting memiliki status hipertensi pada ibunya saat hamil sebanyak 43,51% dan pada bayi serta balita yang stunting memiliki status tidak hipertensi pada ibunya saat hamil sebanyak 56,49%. Kesimpulan: ada hubungan antara tekanan darah tinggi dengan kejadian stunting anak. Kata kunci: stunting; tekanan darah tinggi; kesehatan anak

Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)

Background Despite significant progress in reducing child undernutrition, Bangladesh remains among the top six countries globally with the largest burden of child stunting and has disproportionately high stunting prevalence among the urban poor. We use population representative data to identify key predictors of child stunting in Bangladesh and assess their contributions to linear growth differences observed between urban poor and non-poor children. Methods We combined six rounds of Demographic and Health Survey data spanning 2000-2018 and used official poverty rates to classify the urban population into poor and non-poor households. We identified key stunting determinants using stepwise selection method. Regression-decomposition was used to quantify contributions of these key determinants to poverty-based intra-urban differences in child linear growth status. Results Key stunting determinants identified in our study predicted 84% of the linear growth difference between urban poor and non-poor children. Child’s place of birth (27%), household wealth (22%), maternal education (18%), and maternal body mass index (11%) were the largest contributors to the intra-urban child linear growth gap. Difference in average height-for-age z score between urban poor and non-poor children declined by 0.31 standard deviations between 2000 and 2018. About one quarter of this observed decrease was explained by reduced differentials between urban poor and non-poor in levels of maternal education and maternal underweight status. Conclusions Although the intra-urban disparity in child linear growth status declined over the 2000-2018 period, socioeconomic gaps remain significant. Increased nutrition-sensitive programs and investments targeting the urban poor to improve girls’ education, household food security, and maternal and child health services could aid in further narrowing the remaining linear growth gap.

Effects of Parental Education and Wealth on Early Childhood Stunting in Bangladesh

Background Malnutrition is considered to be a major public health challenge, which is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the effects of parental education and wealth on different specification of stunting among 17490 children below five years of age in Bangladesh. Methods Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17490 children (aged < 5 years) from 64400 households. Multiple logistic regressions were used to determine the risk factors associated with child stunting and severe stunting. Results The prevalence of stunting and severe stunting for children was 25.96% and 7.97%, respectively. Children aged 24 to <36 months [Odds Ratio (OR) = 2.65, 95% CI: 2.30, 3.05] and aged 36 to <48 months [OR = 2.33, 95% CI: 2.02, 2.69] had more risk of stunting compared to the children aged <6 months. Children from Sylhet division had the greatest risk of stunting of all the eight divisions [OR = 1.26, 95% CI: 1.09, 1.46]. Children of secondary complete or higher educated mothers were less likely to develop stunting [OR = 0.66, 95% CI: 0.56, 0.79] compared with children of mothers having no education at all. Similarly, children of secondary complete or higher educated father [OR = 0.74, 95% CI: 0.63, 0.87] were found to have lower risk of stunting compared with children whose father hadn’t any education. Substantially lower risk of stunting was observed among children whose mother and father both completed secondary education or above [OR = 0.59, 95% CI: 0.52, 0.69]. Children from richest households [OR = 0.49, 95% CI: 0.41, 0.58] had 51 % smaller odds on stunting compared to children from poorest families. Conclusions After controlling for socioeconomic and demographic factors, parental education and household position in wealth index were found as to be the most important determinants of child stunting in Bangladesh.

Mapping Nutrition Interventions in Guatemala to Identify Opportunities to Improve Coverage and Coordination

Background: Guatemala has one of the highest rates of chronic child malnutrition (stunting) in the world, with minimal improvements over time, despite intensifying efforts. In 2018, a mapping effort was conducted with nutrition stakeholders, modelled after similar successful efforts in other countries.Methods: A public-private consortium used a survey to collect information from non-governmental nutrition stakeholders in Guatemala, including institutional name, sector, geographic areas of activities, and types of activities implemented. The survey data were used to populate an online mapping tool (ArcGIS Online). The distribution of institutions and programmatic activities at the departmental level was compared to child stunting prevalence using heat maps and linear regression. Geographic distribution of nutrition-specific and nutrition-sensitive activities aligning with Guatemala's four national strategy pillars (primary care services; education and behavior change; water sanitation and hygiene; and household income generation) were examined.Results: 5,861 program activities from 99 institutions were mapped. The majority of institutions were national non-governmental, community-based, or private sector organizations. Heat maps and statistical analysis demonstrated some misalignment between the distribution of resources versus national strategy priority areas and nutrition need. There were a low number of education and behavior change activities at a national level and relatively few primary care and health-sector strengthening activities in some priority departments.Conclusions: Mapping stakeholder institutions and nutrition activities in Guatemala identified several areas where resource allocation could be optimized to better address child stunting. The mapping initiative has been incorporated into Guatemala's national planning process and can assist with future monitoring efforts.

What explains the large disparity in child stunting in the Philippines? A decomposition analysis

Objective: About a third of under-five Filipino children are stunted, with significant socio-economic inequality. This study aims to quantify factors that explain the large gap in stunting between poor and non-poor Filipino children. Design: Using the 2015 Philippine National Nutrition Survey (NNS), we conducted a linear probability model to examine the determinants of child stunting then an Oaxaca-Blinder decomposition to explain the factors contributing to the gap in stunting between poor and non-poor children. Setting: Philippines Participants: 1, 881 children aged 6-23 months Results: The overall stunting prevalence was 38.5% with significant gap between poor and non-poor (45.0% vs. 32.0%). Maternal height, education, and maternal nutrition status account for 26%, 18%, and 17% of stunting inequality, respectively. These are followed by quality of prenatal care (12%), dietary diversity (12%), and iron supplementation in children (5%). Conclusions: Maternal factors account for more than 50% of the gap in child stunting in the Philippines. This signifies the critical role of maternal biological and socio-economic circumstances in improving the linear growth of children.

Progress in child stunting across the world from 1990 to 2015: testing the global convergence hypothesis

Objective: This study has two-fold objectives: first, to test the global convergence hypothesis in the progress of child stunting across 174 countries over the period 1990–2015; second, to identify factors determining the process of convergence or divergence. Design: The study design comprises macro-level cross-country analyses. Our empirical strategy uses parametric convergence models such as absolute and conditional β-convergence models, while non-parametric convergence models such as Kernel density plots serve as robustness checks. Setting: The study uses a global setting comprising child stunting information from 174 countries. Participants: The participants for this study are 174 countries. The information on child stunting prevalence for most countries is available from the UNICEF-WHO-WB Joint Child Malnutrition Estimates Expanded Database (April-2019), while national-level surveys are used for those countries where UNICEF-WHO-WB Database is not available. The data for socio-economic variables are taken from the World Bank’s data bank (1990–2015). Results: Findings from the absolute β-convergence model estimates show that progress in child stunting has diverged over the entire period (1990–2015). However, the speed of divergence has reduced for the recent period (2010–2015). The conditional β-convergence model estimates show that cross-country heterogeneity in GDP per capita, poverty and health care expenditure are significant factors explaining divergence in child stunting. Conclusions: For replacing current divergence with convergence in child stunting worldwide, the study demonstrates the critical role of economic factors and public spending on health care to reduce child stunting, particularly in countries where progress is slow.